Epithelioid leiomyosarcoma: a rare uterine cancer
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20181378Keywords:
Epithelioid, Immunohistochemistry, Leiomyosarcoma, PostmenopauseAbstract
A uterine epithelioid leiomyosarcoma is a rare malignant tumour that arises from the smooth muscle lining the walls of the uterus. The exact cause of leiomyosarcoma, including uterine leiomyosarcoma accounting for 5 to 10% is unknown. Leiomyosarcoma is the most common subtype of uterine sarcoma, accounts for 1-2% of uterine malignancies. Malignancy should be suspected in menopausal women with tumour growth who are not on hormonal replacement therapy. A 64-year-old female had attained menopause 16 year back and developed postmenopausal bleeding since 2 months, with palpable mass, of 16 weeks size. Ultrasonography showed whorled mass lesions, endometrium and myometrium could not be seen separately. Uterus with both ovaries removed. Intra-operative findings showed 16 weeks uterine mass with size 15×10.5×10cm and weight 1kg with intramural fibroid. Necrotic and haemorrhagic areas with degenerative changes seen on cut section suggestive of malignancy. Histopathology and immunohistochemistry reported epithelioid leiomyosarcoma.
References
Norris HJ, Zaloudek CJ. Mesenchymal tumors of the uterus. In: Blaustein A. Pathology of the Female Genital Tract. 2nd Ed. New York: Springer; 1982:352.
Weaver MJ, Abraham JA. Leiomyosarcoma of the bone and soft tissue: a review. Electronic sarcoma update newsletter. 2007;4.
Buscema J, Carpenter SE, Rosenshein NB. Epithelioid leiomyosarcoma of the uterus. Cancer. 1986;57:1192-6.
D’Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol. 2010;116:131-9.
Perri T, Korach J, Sadetzki S. Uterine leiomyosarcoma: does the primary surgical procedure matter?. Int J Gynecol Cancer. 2009;19:257-60.
Harlow BL, Weiss NS, Lofton S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst. 1986;76:399-402.
Bartsich EG, Bowe ET, Moore JG . Leiomyosarcoma of the uterus. A 50-year review of 42 cases. Obstet Gynecol. 1968;32:101-6.
Kurman RJ, Norris HJ. Mesenchymal tumors of the uterus. VI. Epithelioid smooth muscle tumors including leiomyoblastoma and clear-cell leiomyoma: a clinical and pathologic analysis of 26 cases. Cancer. 1976;37:1853-65.
Appleman HD, Helwig EB. Gastric epithelioid leiomyoma and leiomyosarcoma (leiomyoblastoma). Cancer. 1976;38:708-28.
Livi L, Paiar F, Shah N. Uterine sarcoma: twenty-seven years of experience. Int J Radiat Oncol Biol Phys. 2003;57:1366-73.
Major FJ, Blessing JA, Silverberg SG. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993;71:1702-9.
Zaloudek CJ, Norris HJ . Mesenchymal tumors of the uterus . In: Fenoglio CM, Wolff M, eds. Progress in Surgical Pathology. New York: Masson; 1981;3:1-35.
Evans HL, Chawla SP, Simpson C. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer. 1988;62:2239-47.
Atkins K, Bell S, Kempson M. Myxoid smooth muscle tumors of the uterus. Modern Pathol. 2001;14:132A.
Toyoshima M, Okamura C, Niikura H. Epithelioid leiomyosarcoma of the uterine cervix: a case report and review of the literature. Gynecol Oncol. 2005;97:957-60.
Wang WL, Soslow R, Hensley M. Histopathologic prognostic factors in stage I leiomyosarcoma of the uterus: a detailed analysis of 27 cases. Am J Surg Pathol. 2011;35:522-9.
